Video: Prophylactic Antibiotics for Prevention of Endometritis Following Manual Extraction of Placenta

This study, presented at a poster session at ACOG's Annual Clinical Meeting, examined 228 cases of manual extraction of the placenta to determine whether prophylactic antibiotics reduced the incidence of endometritis. Watch the video or read the transcript, below.

Hi, I’m Dana Baras. I’m from VCU Medical Center in Richmond, Virginia. My topic is Prophylactic Antibiotics for Prevention of Endometritis Following Manual Extraction of Placenta. In this study, we looked at 228 cases of manual extraction of the placenta and looked at whether the patients had received antibiotics, specifically prophylacticly against infection. In addition, we collected data on whether the patients had received antibiotics for other conditions, like GPS during their labor or whether they’d received no antibiotics at all.

In our study, prophylactic antibiotics, when given, showed a 0% rate of infection whereas other antibiotics showed a 2.53% whereas no antibiotics were 4.29%. Interestingly, when we broke this down into the number of cervical exams the patient had had, women who had over six cervical exams ended up having a large increase in endometritis when no prophylactic antibiotics were given, compared to women with zero to five cervical exams.

In summary, women with six or more cervical exams were found to have a significant negative association between increased specificity of antibiotic prophylactics and the rate of endometritis. This data suggests that women who have more than six cervical exams are most likely to benefit from prophylactic antibiotic coverage to prevent endometritis, as they represent a more at-risk group for the development of endometritis.